Exam 4 Flashcards
What is a normal BNP?
less than 100 pg/ml
- the higher the number, the greater chances of heart failure,
If a patient is unable to walk on a treadmill for a stress test, what other methods could be used?
a. Vasodilating agents such as dipyridamole, adenosine, or regadenoson
b. Vasodilating agents such as dipyridamole, adenosine, or regadenoson given as an IV infusion are used to mimic the effects of exercise by maximally dilating normal coronary arteries and identifying stenotic arteries that cannot vasodilate.
increased hypertension increases risk for
stroke and MI
Medications given for high blood pressure
The main diuretic for high blood pressure treatment is thiazide. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill. Beta blockers help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels.
What is the difference between hypertensive urgency and emergency
- Hypertensive Urgency can be treated with oral or IV medications on the floor with individual doses.
- Emergency is more severe and has organ failure
What to ask a patient with high blood pressure?
Did you take any high blood pressure meds
If patient is taking diaretics, what electrolyte must your check?
POTASSIUM
Uncontrolled high blood pressure means the patient is not…
taking their medications
Goal of medications for hypertension is to
- lower the blood pressure
- prevent further organ damage
When the distal tip of the catheter’s balloon that lies in the main pulmonary artery is inflated, what is being measured?
The pulmonary artery wedge pressure
What should you monitor in a patient taking blood pressure medications (prils, arbs, lols, aces)?
Potassium
Stage 1 and stage 2 hypertension
Stage 1: 130 to 139 (systolic) or 80 to 89 (diastolic)
Stage 2: 140 or higher (systolic) or 90 (diastolic)
BUN lab Range
7-20 mg/dL
Creatine Lab Range
0.6 to 1.2 mg/dL
Patient has orthostatic hypertension. what should you tell them
Don’t get up too fast to reduce the risk of falling
Medication treatments for Hypertension
Calcium Channel Blockers – Pine, amil
b. Angiotensin Receptor Blocker (ARBs) – artan
c. ACE inhibitors – pril
d. Beta-Blockers – olol
e. ***Thiazide are diuretics and not considered to be in the family of blood pressure medications even though it is used for blood pressure
With hypertensive emergency, the goal is to normalize the blood pressure within how many hours?
a. Reduce blood pressure by no more that 25% in the first hour
b. 160/100 within 2-6 hours
c. Then gradual reduction to normal 24-48 hours of treatment
If a patient has peripheral artery insufficiency, what should the nurse include in their teaching?
a. Lower the extremity
b. For patients with PAD, blood flow to the lower extremities needs to be enhanced; therefore, the nurse encourages keeping the lower extremities in a neutral or dependent position.
A patient is diagnosed with venous thromboembolism (VTE), how would a nurse explain this condition to the patient?
a. Venous stasis
b. Altered coagulation
c. Blood swelling
risk factors associated with thromboembolism
a. endothelial damage
b. venous stasis
c. altered coagulation
Components of a cardiac assessment
a. Health history
b. Demographic information
c. Family/genetic history
d. Cultural/social factors
e. Risk factors; Modifiable and Nonmodifiable
Patient has acute coronary artery syndrome. what labs are monitored
a. Troponin
b. creatine kinase (CK-MB) – heart muscle
c. myoglobin
What does a right cardiac cath measure
pulmonary artery pressure.
it is in the right atrium, right ventricle and pulmonary artery
When a pulmonary artery catheter is inflated and the pulmonary artery wedge pressure is measured in a critically ill patient, what will the results and measurements be used to assess for?
a. left ventricular preload
b. Monitoring of the pulmonary artery diastolic and pulmonary artery wedge pressures is particularly important in critically ill patients because they are used to evaluate left ventricular filling pressures (i.e., left ventricular preload).
What is a measurement of the pressure in the vena cava or right atrium and also reflects the filling pressure of the right ventricle (pre-load)?
a. CVP (central venous pressure)
b. The normal CVP is 2 to 6 mm Hg
creatine reactive protein (CRP) measures
inflammation
- higher than 1.0 mg/dL indications inflammation but not the location or cause.
- a protein produced by the liver in response to systemic inflammation
Normal BP is
120/80
- Systolic <120 mm Hg and Diastolic <80 mm Hg
Patient education for pulmonary artery disease
STOP SMOKING
what tool is used if you can’t feel a patient’s pulse
Continuous wave (CW) Doppler Ultrasound
A patient with atherosclerosis should stop what immediately?
Stop smoking
Patient with high blood pressure and Decreased vision is at risk for
Retinal bleeding due to high blood pressure (retinal hemorrhages)
High Central venous pressure (CVP) symptom
Fluid volume overload (hypervolemic)
If you have heart failure on the left side of the heart, what system of the body will be affected?
Respiratory system
Low CVP symptom
Fluid volume deficit (hypovolemic)
Increased hypertension can put a patient at risk for hypertension?
Heart attack
Hypertensive emergency
- organ failure
- Blood pressure >180/120 mm Hg
Hypertensive urgency
Blood pressure >180/120 mm Hg
normal range for CVP (Central Venous Pressure)
2-6
components of a physical cardiac assessment
a. General appearance
b. Skin and extremities
c. Pulse pressure
d. Blood pressure; orthostatic changes
e. Arterial pulses
f. Jugular venous pulsations
g. Heart inspection, palpation, auscultation
h. Assessment of other systems
What does a BNP lab test for?
a. Heart Failure
b. The BNP level is a key diagnostic indicator of HF; high levels are a sign of high cardiac filling pressure and can aid in both the diagnosis and management of HF.
What is used in critical care for assessing left ventricular function, diagnosing the etiology of shock, and evaluating the patient’s response to medical interventions (e.g., fluid administration, vasoactive medications)?
Pulmonary artery pressure monitoring
In addition to obtaining pressure readings, the CVP catheter is used for what else?
a. infusing IV fluids
b. administering IV medications
c. drawing blood specimens
A patient with high blood pressure is at risk for having what?
Stoke and heart attack
With hypertensive urgency, the goal is to normalize the blood pressure within how many hours?
24-48 hrs
